Abdul Rehman, Mukhtar Ahmad, Tauseef Asma Chaudhry, Shahzadi Asma Tehseen.
The efficacy of diosmectite in admitted children having acute watery diarrhea with dehydration.
Pak Paed J Jan ;37(2):91-4.

Objective: To determine the effect of diosmectite in reducing the duration of diarrhea in comparison with placebo. Method and Material: This randomized open clinical trial was conducted in the Pediatric Unit-I Bahawal Victoria Hospital Bahawalpur from 10th January to 30th June 2011. Children aged 6-24 months admitted with acute watery diarrhea of duration ≤72 hours but ≥24 hours and having some dehydration/severe dehydration were included. The patients were allotted group A (Diosmectite group) or group B (placebo group) by the lottery method. After the initial hydration Diosmectite at a dose of one gram in children below 12 months of age and 1.5 grams in children 12-24 months of age three times a day diluted in water or other semi-solid food along with zinc sulphate was administered orally for 5 days to group A while group B was given placebo (oral zinc sulphate). All the study participants were followed from the beginning of therapy to normalization defined as the passage of first stool of prediarrheal consistency (hours) and maximally for six days from the beginning of therapy in case of failure to pass stool of prediarrheal consistency. Results: There were103 children in each group who were initially recruited for the study. 99(96.12%) children from diosmectite group and 97(94.17%) children from placebo group completed the study. Both the group had similar characteristics. There were 6 out of 99 cases from diosmectite group while 7 out of 97 cases from placebo group who failed to pass stool of prediarrheal consistency at the end of six days after initiation of treatment (p value 0.782). The time taken to pass first stool of prediarrheal consistency (hours) in the rest 93 cases from diosmectite group was 58.935±30.482 while the time taken to pass first stool of prediarrheal consistency (hours) in the rest 90 cases from placebo group was 76.511±35.323 (p value 0.0004). This showed that drug was moderately effective as compared to placebo. Conclusion: Smectite may be a useful adjunct to rehydration therapy in treating acute watery diarrhea in children but cost-effective studies are needed before recommending its routine use.

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